title: Effects of electromyostimulation on muscle and bone in men with acute traumatic spinal cord injury: A randomized clinical trial.
abstract: OBJECTIVE
  To study the effect of 14 weeks of electromyostimulation (EMS) training (47 minutes/day, 5 days/week) on both muscle and bone loss prevention in persons with recent, complete spinal cord injury (SCI).
  
  
  METHODS
  Prospective, experimental, controlled, single-blind randomized trial with external blind evaluation by third parties.
  
  
  METHODS
  Eight men with recent SCI (8 weeks from injury; ASIA Impairment Scale (AIS) "A") were randomized into the intervention or the control groups. Cross-sectional area of the quadriceps femoris (QF) muscle was quantified using magnetic resonance imaging. Bone mineral density changes were assessed with a dual-energy X-ray absorptiometry. Several bone biomarkers (i.e. total testosterone, cortisol, growth hormone, insulin-growth factor I, osteocalcin, serum type I collagen C-telopeptide), lipid, and lipoprotein profiles were quantified. A standard oral glucose tolerance test was performed before and after the 14-week training. All analyses were conducted at the beginning and after the intervention.
  
  
  RESULTS
  The intervention group showed a significant increase in QF muscle size when compared with the control group. Bone losses were similar in both groups. Basal levels of bone biomarkers did not change over time. Changes in lipid and lipoprotein were similar in both groups. Glucose and insulin peaks moved forward after the training in the intervention group.
  
  
  CONCLUSIONS
  This study indicates that skeletal muscle of patients with complete SCI retains the ability to grow in response to a longitudinal EMS training, while bone does not respond to similar external stimulus. Increases in muscle mass might have induced improvements in whole body insulin-induced glucose uptake.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Arija-Blázquez
authors.forename: Silvia
authors.initials: S
authors.lastname: Ceruelo-Abajo
authors.forename: María S
authors.initials: MS
authors.lastname: Díaz-Merino
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Godino-Durán
authors.forename: Luís
authors.initials: L
authors.lastname: Martínez-Dhier
authors.forename: José L R
authors.initials: JL
authors.lastname: Martin
authors.forename: José
authors.initials: J
authors.lastname: Florensa-Vila
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D001842:Bone and Bones / Q000502:physiology; D004599:Electric Stimulation Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D009133:Muscular Atrophy / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D010024:Osteoporosis / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Biological markers; Bone density; Electric stimulation; Paraplegia; Skeletal muscle; Spinal cord injuries; Tetraplegia